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Miracle Work on 38th Street: Connecting a Family at Life’s End

In my work at Seton Healthcare Family, I had the privilege of interviewing this family about their experience in one of our hospitals. All they wanted was time for the father to say goodbye. They got a great deal more.  

“We expected to visit the hospital, get him stabilized and then take him back home. Suddenly, everything changed.”


Eduardo’s sister, Cecilia, holds a photo of him at school.

On a humid Sunday morning, a young man with Down syndrome entered the emergency room at Seton Medical Center Austin (SMCA), part of the Seton Healthcare Family, Austin, Texas. Accompanied by his mother and sister, he struggled to breathe. Thirty-two-year-old Eduardo Martinez had recently been diagnosed with kidney disease and was told he had six months to a year left. Within the hour, the prognosis changed dramatically. Eduardo was given less than two days to live.

“We were floored when the doctor told us the news,” said Cecilia Martinez, Eduardo’s sister. “We expected to visit the hospital, get him stabilized and then take him back home. Suddenly, everything changed. I started calling family to come to the hospital.”

Though Eduardo’s mother is local, his father lives in Mexico and had not seen Eduardo in 16 years. The family asked Seton to help the father cross the border and say goodbye.

Enter Dr. Truly Hall and Eileen West. Dr. Hall is the director of the Seton Adult Inpatient Medical Services (SAIMS) program at SMCA, which is on 38th Street in Austin. She is board certified in internal medicine, with seven years at Seton under her belt. Eileen West is a medical social worker at SMCA, spending every other Monday through Friday in the 4-North unit. On the weekends her role expands to “the whole house,” meaning she covers all cases that are not in the Emergency Department or labor and delivery.

Around 2 p.m. that Sunday, West received a call from Dr. Hall about a family standing vigil in the ICU for their terminally ill son. The request for border crossing assistance was not a surprise. “Maybe once a year we have a case like this, and I’ve written to the Mexican Embassy for an emergency visa,” said Dr. Hall. “But never on a Sunday.”

Given the political upheaval at the Texas/Mexico border, West was concerned. “I said I’d get right on it, but then realized the Mexican Embassy was closed,” she said. West spoke with Cecelia and decided to contact the U.S. Customs and Border Protection, since the family knew which one of the 26 crossing stations the father was going to enter.

How did she know where to start? “I just Googled it,” she said nonchalantly. “I got a phone number, then was transferred and passed around a bit, but I ended up on the phone with a humanitarian care unit.”

To cross the border on such short notice, Eduardo’s father required detailed paperwork. Dr. Hall and West compiled six pages of materials outlining the situation. West provided Border Patrol agents with her personal cell phone, work phone and home phone. Then she hit a snag.

“The Border Patrol told me that I needed to give the paperwork to the family, and that the family should deliver the documents to the father at the border,” said West. “But I told them,  ‘No. This young man is dying and the family is not leaving his side.’” Several faxes later, the paperwork was approved.

The U.S. Citizenship and Immigration Services allows foreign residents to apply for humanitarian parole for emergency situations. Handled on a case-by-case basis, approval generally takes between 60 and 120 days. With West’s tenacious prodding, it took mere hours. West attributes her success to “A bit of luck – and someone must have taken pity on us!”

Meanwhile, Eduardo continued receiving comfort care. “Every single doctor, nurse, all the people we met – they are great people,” recalled Cecelia. “We moved Eduardo to the third floor, and the nurses brought us pillows, blankets and a folding bed. Someone from the ICU made sure that we got a bigger room so we could all be near Eduardo. Even though it was a tough situation, the doctors and nurses never treated us or Eduardo dismissively. They knew it was hard.”

A fitful night passed as the family waited. At 9 a.m. the next day, Eduardo’s face split into a grin when his father walked into the room. As Cecilia described it, “I kept saying, ‘Wow.’ We didn’t expect him to cross the border at all, especially on a Sunday. I am so impressed by Eileen. She was an angel for us.”

Cecilia isn’t the only one impressed by West’s actions. “A lot of social workers — especially on a Sunday — they wouldn’t even have tried to help the family, and no one would have batted an eye, considering she was also covering the whole house,” said Dr. Hall. “The chaotic border situation didn’t deter her; Eileen took care of everything. I don’t know how she did it!”

Garry Olney, vice president and chief operating officer at SMCA concurred, adding, “This is amazing! It is what Humancare is all about. Eileen did a great job.”

Lifted spirits were short-lived, however. Over the next few days, Eduardo’s condition deteriorated. In his final hours a nurse noticed the family focused on the plummeting numbers and screeching beeps of the monitors surrounding him. She disconnected the monitors and encouraged the family to focus on Eduardo, adding, “He is more important than any numbers.”

Thanks to West’s thorough initial work, Eduardo’s father was able to stay in town long enough to attend the burial. When asked why she went to such great lengths for this family, Eileen’s answer was simple: “The most important thing I could do for the family was to get the father here.”

She downplayed the significance of her actions, adding, “Every social worker does this; it’s not out of the ordinary in our department. In fact, this is what many social workers accomplish before their first cup of coffee or morning rounds!” Caffeinated or not, West exemplifies Humancare, going above and beyond her required duties to impact lives.

Cecilia has a message for the staff at SMCA: “We are very thankful for Seton. From the ER to the final day in the hospital, everybody treated us like family. A lot of people discriminate against people with disabilities, but Seton showed great love and care for my brother. There are several hospitals we could have gone to and we ended up at the right one. We received so much support. I don’t have the words to describe the experience. Please tell all the Seton staff thank you.”

About Humancare

Humancare challenges the status quo of healthcare. By adding humanity back into a system that seems to have lost its human touch, we’re moving closer to being able to provide person-centered care. This recommitment to the people we serve modernizes our mission to care for and improve the health everyone in Central Texas, and beyond. Humancare is how we bring our mission to life, everyday. On this page you’ll find resources to help you understand, experience and share Humancare. setonhumancare.org

Impress-Your-Guests Chocolate Bundt Cake

This easy breezy chocolate cake is a total hit. Every time. Everywhere. With everyone.

I first sampled this delectable happiness when a friend made it for bookclub. She, in turn, says, “I got the recipe from my Aunt. She makes it for special occasions. It is probably a cake doctor recipe from 10 years ago. It’s always a hit with chocolate fans!”

IngredientsImage

1- Devil’s food cake mix (make sure it does not already have pudding in the mix)
1- 5.9 oz pkg chocolate pudding (if you can only find the 3.9 oz, that’s fine, just reduce the bake time 5 minutes)
4 eggs
1/2 cup vegetable oil
1 cup regular or light sour cream
12 oz semi-sweet mini morsel chocolate chips (you can use regular chips but the minis distribute a bit more evenly)

Directions
Mix the first five ingredients together. Stir in the chips and mix another minute or so. Pour batter into a greased bundt pan. Bake at 350 degrees for 50-60 minutes. Cool at least 15 minutes in the pan before inverting and removing the cake from the pan. Sprinkle with powdered sugar if desired. Ooh and ahh. 

Saying the word “bundt” brings to mind this vignette from “My Big Fat Greek Wedding”: https://www.youtube.com/watch?v=WPvO53JHnmY 

Better-for-you Butter Chicken

According to my fiance, this should be called “Righteous butter chicken.”

I love butter chicken and order it every chance I have. Officially known as ‘murgh makhani’ and described as ‘Indian chicken in tomato cream sauce,’ I’m rarely disappointed. This is baby Indian food — almost zero heat, sweet and hard to resist seconds, or thirds.

However, generally I place it in the category of ‘foods best made by others’ since the amount of cream sends my stomach racing into hiding. To avoid lactose overload, I gave this version from Natural Noshing a try. It’s light on dairy but still full on flavor, and can easily be made lactose free. Overall assessment: it’s good. It’s not EPIC or a copycat recipe but it’s solid.

Next time I’ll use vegetable or peanut oil, though. I apparently don’t like the scent of heated coconut oil; it reminds me of being stuck in a car on a hot day with a box of melting crayons and a coloring book. Also, lemon juice is an absolute must for finishing the dish. I’ve made the changes that I will make next time to the recipe below.

TIP: This will take you about 2 hours, start to finish.

Ingredients for the Chicken:
4 skinless, boneless chicken breasts
2 cups yogurt (can use dairy-free options)
2 TBS ginger-garlic paste
1 tsp salt or to taste
1 tsp cumin powder
1 tsp garam masala
1 tsp cayenne pepper
3 tsp tandoori masala powder
2 tsp kasuri methi or 1 tsp ground dried fenugreek seeds
4 TBS canola oil, coconut oil or other neutral oil

Directions For the Chicken:
1. In a small bowl mix together cumin, garam masala, salt, cayenne pepper, tandoori masala and fenugreek/kasuri methi. Rub on both sides of the chicken and refrigerate for at least 30-60 minutes.
2. Line a pan with parchment or foil. In a large bowl, whisk together yogurt, oil and ginger garlic paste. Dip each chicken breast into the yogurt mixture. Coat well. Lay on prepared pan.
3. Heat oven to broil and cook 10-18 minutes or until cooked through (depending on thickness of chicken), flipping them over halfway through. For 4 meaty breasts, I cooked 15-20 minutes on each side. When cooked through, let chicken rest for 5 minutes. Optional: slice chicken into 1 inch cubes.

Ingredients for the Butter Sauce:
4 TBS coconut oil, canola oil or other neutral oil
2 medium onions, thinly sliced
3 TBS ginger-garlic paste
4 cups diced tomatoes (use canned or marinara to save time)
2 TBS flour
1 tsp cayenne pepper
2 tsp cumin powder
2 tsp garam masala
3 TBS kasuri methi or 1 tsp dried ground fenugreek seeds
1/2 tsp sea salt
1 TBS sugar or sweetener of choice
1/2 cup coconut milk OR greek yogurt OR  sour cream
4 TBS butter, ghee, or margarine
Juice of 1 lemon

Directions For the Butter Sauce:
1. Heat the oil in a medium sauté pan. Cook onions until soft and translucent. Add ginger-garlic paste and stir for about 1 minute.
2. Add tomatoes, flour, cayenne, cumin, garam masala, kasuri methi, salt and sugar. Cook on medium heat until thick. Optional: Puree sauce in a blender and return to the pan. Personally I find blending hot liquids in batches a messy business.
3. Add dairy (yogurt/coconut milk/sour cream) and butter. Stir and cook for another 5 minutes. Add lemon juice. Taste and adjust. If you prefer a thinner sauce, add a bit more coconut milk.
4. If you opted to cut up the chicken, add it to the pan and simmer for a few more minutes. I sliced up the chicken and poured sauce over it instead.

Serve hot with lentils, rice and buttery garlic naan. Sigh contentedly and enter righteous butter chicken food coma.

 

Homemade Oatmeal Creme Pies (Take 1)

I’ve decided – for no particular reason – that 2014 is the year of making oatmeal creme pies. I started with this recipe from Cooking Classy, and made a few minor tweaks as a newbie to this realm of cookie sandwiches. I don’t know how they managed to make these in 25 minutes, as it took me 2 hours, but the end result is pretty impressive. And by that I mean that the creme filling made unicorns cry tears of joy. I will never make another frosting again.

In the words of the Birthday Boy & Official Taste-tester, “Seriously, it is so damn good. You nailed it, hun.”

Ingredients

1 3/4 cups + 2 Tbsp all-purpose flour
1 cup quick oats
3 tsp cocoa powder
1 1/2 tsp cornstarch
1 tsp baking powder
1/2 tsp baking soda
3/4 tsp salt
1 tsp cinnamon
1/4 tsp ground nutmeg
1/4 tsp ground ginger
1/2 cup butter, softened
1/2 cup shortening (unflavored)
1 1/4 cups granulated sugar
3 TBS molasses
2 large eggs (or egg product)
1 tsp vanilla extract
1/8 tsp almond extract

Marshmallow Buttercream Filling
1/2 cup butter, nearly at room temperature
1/4 cup shortening (unflavored)
1 1/2 cups powdered sugar
7 oz. marshmallow creme

Directions

1. Preheat oven to 350 degrees. In a mixing bowl, whisk together flour, oats, cocoa powder, cornstarch, baking powder, baking soda, salt, cinnamon, nutmeg and ginger, set aside. In the bowl of an electric stand mixer, whip together butter, shortening, sugar and molasses on medium-high speed until pale and fluffy, about 2 minutes. Stir in eggs, mixing until combine after each addition. Mix in vanilla and almond extract. Slowly add in dry ingredients and mix until well combined.

2. Scoop dough out about 2 Tbsp at a time and drop on cookie sheet lined with a Silpat or parchment paper. Depending on size, you can fit 6-9 per sheet. Bake in preheated oven 10 – 12 minutes. Cookies should still be soft, not fully set – don’t over bake. My oven runs hot so I pulled them out at 9 minutes, since 11 minutes made a batch of crunchy granola bars.

3. Allow to cool several minutes on baking sheet before transferring to wire rack to cool. Cool completely then spread marshmallow buttercream filling along bottom side of one cookie and sandwich to the bottom side of another cookie. Store cookies in an airtight container at room temperature.

4. To make the marshmallow buttercream filling:
In the bowl of an electric stand mixer  or hand mixer (not an immersion blender, folks), whip butter and shortening on medium-high speed, until pale and fluffy, about 3 – 4 minutes. Add powdered sugar and blend on low-speed until combined, then increase speed to medium-high and whip for 1 minutes. Mix in marshmallow creme and taste. Try not to keel over in drooling bliss. 

The cookies are good, but not enough of an improvement over the classic Quaker Oats recipe that I’d say you have to use this recipe.  For Take 2, I’m looking at these Oatmeal Buttercream Pies. Any other recipe suggestions?

Winter White Cosmopolitan

Thanks to Bonefish Grill, I have a new favorite holiday drink: winter white cosmopolitan. I tossed back two of these and could happily have finished an entire pitcher.

TIP: Don’t skimp on the shaking and martini glass presentation –  the icy chill makes this drink sparkle.

Ingredients
2 oz. cranberry vodka
2 oz. white cranberry juice
.75 oz Cointreau
1 oz. sweetened lime juice (mixture of lime juice and simple syrup)
3-4 raw cranberries, for garnish

Directions: Fill a cocktail shaker with ice. Add cranberry juice, vodka, Cointreau and lime juice. Shake to combine well. Strain into a chilled martini glass and top with 3-4 cranberries.

Verdict: Dangerously delicious

The Best Vegetarian Chili

This is no ordinary, ho-hum watery veggie bean chili. This recipe is smoky, complex, rich in flavor and texture. We made this for a pumpkin party and everyone RAVED, then asked for the recipe and for seconds. I’m on day 3 of leftovers and am still happy to eat this. I recommend serving it with Pumpkin Cornbread and all of the garnishes your heart desires. Really, make this chili. The recipe serves 12-15. It can be halved, as in the original version from from Saveur.

INGREDIENTS
2 cans dark kidney beans
2 cans pinto beans
1⁄2 cup extra-virgin olive oil
24 cloves garlic, minced (I totally used the pre-minced stuff in a jar)
1 can chipotle chiles in adobo sauce (Chop all the chiles except for 3. Reserve the adobo sauce for extra heat if desired.)
4 bay leaves
1 large white onion, chopped
1 large red onion, chopped
1-2 jalapenos, minced
16 oz. button mushrooms, quartered
12 medium tomatoes, chopped
2 cans canned hominy, drained
1 cup tomato paste
4 TBS. red wine vinegar
4 tsp. fresh thyme leaves
2 tsp. dried oregano
3 tsp. ground cumin
½ tsp. chili powder
1 package sun-dried tomatoes, chopped
Freshly ground black pepper, to taste
Kosher salt, to taste
Sour cream, to garnish
Minced cilantro, to garnish
Minced red onion, to garnish
Queso fresco, to garnish – Any cheese will work, but this salty, semi-firm option crumbles nicely and looks pretty against the dark colors of the beans and tomatoes.

INSTRUCTIONS
1.      Put kidney beans and pinto beans into a large pot and cover with 3″ water; bring to a boil, reduce heat to medium-low, and simmer, stirring occasionally, until beans are tender, about 45 minutes. Set pot aside.

2.      Heat oil in a VERY large pot over medium-high heat. Add garlic, chipotle chiles, bay leaves, onions, and jalapenos and cook, stirring often, until onions are golden, 12–15 minutes. This smells awesome.

3.      Add mushrooms and cook, stirring often, until tender, about 8 minutes. Add tomatoes and cook, stirring, about 5 minutes. Stir in reserved beans and their cooking liquid, stir to combine.

4.      Add the hominy, tomato paste, vinegar, thyme, oregano, cumin, chili powder, sun-dried tomatoes, and season with salt and pepper. Reduce heat to medium-low and simmer, stirring occasionally, until chili thickens and flavors meld, about 1 hour. Turn off the heat to help thicken, and/or add more tomato paste.

5.      Serve chili topped with sour cream, cilantro, queso fresco and red onions. Prepare for double helpings – and filling tupperwares!

My Crack Snack

It’s true that I wax poetic about sublime hummus and frosty pumpkin beer, savory thai  and luscious dark chocolate (72% cacao!). But the one food that I absolutely cannot stop eating once start, the snack attack that leaves me apologizing for eating the whole bag, the crunch that I no longer purchase is…

Soy Sauce Rice Crackers

These are my crack. I say ‘I’ll nosh on a few,’ and then shove handfuls in my mouth. ‘I’ll just put them in the cabinet,’ I convince myself, and then pop 15 more. ‘I really should leave some for the bf,’ I resolve, and then realize that the bag is nearly empty. ‘It would be rude to leave crumbs, so I’ll just finish ’em off for everyone’s good’ I justify. Salty, crunchy, slightly sweet with that umami taste that does.not.stop.

Though I would never try and seduce someone to have a self-discipline fail (Ha! Like every happy hour),  brands that I can vouch for include:

   

 

 

 

 

 

Perhaps I just need  to embrace my love of salty foods with a purchase that speaks to the heart of the matter.